回盲部憩室炎的超声诊断

背景：急性回盲部憩室炎的临床表现与急性阑尾炎相似，易误诊为急性阑尾炎。近年来，超声检查在胃肠疾病诊断中的应用研究不断深入，但关于回盲部憩室炎超声诊断的报道尚少。目的：探讨超声检查对回盲部憩室炎的诊断价值。方法：纳入17例于2010年2月-2011年12月在天津市西青医院经急诊超声检查诊断为急性回盲部憩室炎，并经手术病理或相关检查证实的患者，对其超声声像图表现及其治疗和预后进行回顾性分析。结果：本组17例患者中，病灶位于盲肠或升结肠者7例，位于回肠末端者10例，包块大小0．62cm×0．80cm-2．30cm×1．32cm。所有患者均于腹部压痛点或其周围探及肠壁向外凸出的圆形或卵圆形包块，包块腔内通常为点状低回声，可伴有气体、液性、粪石样回声。憩室周围可见不同程度的脂肪组织、网膜系膜组织增厚。10例患者接受急诊手术治疗，7例接受保守抗炎治疗。所有患者均治愈，无严重并发症发生。结论：超声检查对回盲部憩室炎的诊断和鉴别诊断具有重要意义，除能早期明确诊断外，还可为临床医师选择正确的治疗方案提供依据。

Diagnosis of Ileocecal Diverticulitis with Ultrasonography

Background： Acute ileocecal diverticulitis is easily to be misdiagnosed as acute appendicitis because the clinical manifestation of the two diseases are similar. Progress has been made on application of ultrasonography for diagnosis of gastrointestinal diseases, however, reports focused on the diagnosis of ileocecal diverticulitis with ultrasonography are still scanty. Aims~： To study the value of uhrasonography in diagnosing ileocecal diverticulitis. Methods： A total of 17 cases of acute ileocecal diverticulitis were enrolled retrospectively from Feb. 2010 to Dec. 2011 at Tianjin Xiqing Hospital. All cases were diagnosed initially with emergency ultrasonography and confirmed by surgical pathology or other imaging technologies. Their sonographic appearance and treatment outcome were reviewed. Results： Of the 17 cases of ileocecal diverticulitis, 7 located at cecum or ascending colon and 10 located at terminal ileum, with the size ranged from 0.62 cmx 0.80 cm to 2.30 cm ~ 1.32 cm. At the area of abdominal tenderness, round or oval masses formed by protruding local bowel were detected by ultrasonography in all 17 cases. The masses displayed hypoechoic pattern and might be complicated with echo of gas, liquid or fecalith in some cases. Around the mass were varying extent of thickened fatty tissue and meso- omentum. Ten cases received emergency operation and 7 received conservative anti-inflammatory treatment. All cases were cured with no major complications. Conclusions： Ultrasonography is of great importance for the diagnosis and differential diagnosis of ileocecal diverticulitis. It is also helpful for selection of optimal therapeutic regimen.